Shofar FTP Archive File: camps/auschwitz/cyanide/cyanide-on-skin

[From Brian Harmon]
Some time ago, I mentioned that i had a source or two
mentioning that cyanide passing thru the skin
was not a major mode of poisoning.
It took me some time, but i dug out a couple
of sources from my photocopied pile of stuff.
The first is from an article in _American Family
Physician_, July '93, V48 n1. on page 109:
"Cyanide is readily absorbed by the mucous membranes
and eyes. Clinical cases of cyanide poisoning after
dermal [skin] exposure are rare and have most oten
involved burns with molten cyanide salts or immersion
in cyanide solutions."
Not much, really, but it's something. This quote is
included in
ftp://nizkor.almanac.bc.ca/pub/camps/auschwitz/cyanide/cyanide.001
Something i never noticed before, however, is the article
mentions how to clinically diagnose cyanide poisoning.
This kind of thing could be very useful in smashing the
denier's crying foul that no one did an autopsy report
on the gassed victims. We already know that none the
corpses were around long enough for allied doctors
to have carried out the autopsy, as the gassing stopped
months before Auschwitz fell. We might be able to take
away there other argument by showing that clinical diagnosis
of cyanide poisoning is difficult on living people, let alone
those who have been dead for some time.
On page 110:
Clinical Evaluation
History and Physical Examination
A pertinent history in a patient suspected
of cyanide poisoning may include occupation
and hobbies, medications, diet, smoking habits,
and drinking water source. Physical examination
of chronically exposed petition should include
particular attention to neuropsychiatric,
opthalamologic, and cardiovascular systems, as
well as thyroid function
Because cyanide can kill quickly, acute poisoning
must be rapidly treated. Unfortunately, diagnosis is
often difficult, especially when the history cannot be
obtained. Knowledge of the patient's occupation, mental
status before poisoning, probability of suicicidal
intent or location at onset of symptoms can be vital in
making a diagnosis.
and on page 111:
Acute Signs and Symptoms
[without going into the details, this lists
ways to diagnose people who are _still alive_
including cardiovascular signs (ST segment
length), breathing, etc.]
...Retinal veins and arteries may appear red
in color as cyanide blocks cellular utilization
of oxygen, elevation venous PO2 [pressure of oxygen]
[..] Non cardiogenic pulmonary edema may be noted
after cyanide inhalation or ingestion. Because of
increased venous PO2 and percent oxygen saturation,
cyanosis may be absent despite respiratory depression.
Severe metabolic acidosis results from anearobic
metabolism with increased lactic acid production.
[..]
Laboratory Tests
Direct Biological indicators
_Blood Cyanide Concentration_. Laboratory analysis
of the whole-blood cyanide concentration takes at least
four to six hours, and theraputic interventions usually
must be made before results are available. However,
determination of whole-blood cyanide levels is useful in
confirming and documenting the diagnosis. One of the
most significant problems in measuring cyanide is its
instability in collected samples. A laboratory should
be consulted for proper techniques in speciment handling.
[discussion about how much cyanide is bad deleted]
Indirect Biological Indicators
_Plasma or Serum Thiocyanate Level_ Cyanide in the
body is biotransformed into thiocyanate. [..] Thiocyanate
can be measured in serum or plasma, but interpretation of
levels in a cyanide-poisoned patient is difficult. Little
correlation has been found between simultaneously obtained
whole-blood cyanide and plasma thiocyanate levels.
=====
A summary and comment:
* Cyanide poisoning causes metabolic acidosis:
this wouldn't be helpful, as asphyxiation also
causes acidosis as CO2 builds in the blood.
* Red venoous blood/higher O2 concentration in blood:
this won't be too helpful once the victim is dead
and stops breathing. Higher O2 can also be caoused
by many other things.
* Whole blood cyanide: Given the instability of the
samples, this could be duff too, but it
work.
* Plasma thiocyanate levels: Given that the victims
died within minutes of gassing, i doubt their livers
will have much time to change any of the cyanide to
thiocyanate.
The other diagnoses mentioned only work for
people who are still alive (dyspnea, cardiovascular
function, disorientation, etc.) Even still, the article
makes no bones about it: diagnosing cyanide exposure is
no easy task.
I have the whole article here, so i can photocopy and mail it
out to you.
-- Brian.

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